NPI | 1942240106 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2085U0001X Radiology, Diagnostic Ultrasound (Licence: UT 274486-1205) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: UT 274486-1205) |
2085R0202X Radiology, Diagnostic Radiology (Licence: ID M-8441) | |
Enumeration Date | 2006-06-07 |
Last Update Date | 2012-10-10 |